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ASGE Answers Your Coding Questions

ASGE members may submit coding inquiries electronically to codingquestions@asge.org. When submitting a question, please allow at least three business days for a response. When submitting inquiries, please include the ASGE member’s name and ID number. Only questions will be accepted and not reports. Below is our featured Coding Question of the Month that could be beneficial to your practice.

Question

Recently we were advised by a representative from the company where we order our breath tests that we should be billing CPT code 91065 twice for each test being performed because the test is inclusive of both hydrogen and methane. So, if the patient does one breath test, and we measure both the hydrogen and the methane, can we/should we bill the code 91065 twice? Or as two units? 

Answer

No, billing CPT code 91065 Breath Hydrogen or Methane Test (e.g., for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit) twice for a single breath test is incorrect. CPT code 91065 covers both hydrogen and methane measurement in a single breath test. You should only bill 91065 once per test, regardless of whether both gases are measured.

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